Best Stuff

for Med Students*

*Pre-meds, Interns and Residents,
you're welcome too

The discovery of a cure for cancer has long been awaited. Although death rates dropped by 25 percent between 1991 and 2014, cancer is still the second leading cause of death in the United States, behind heart disease. In an effort to reach the goal faster, the Cancer Moonshot was created to develop new research, trials and eventual treatment methods. Designated by former President Barack Obama in 2016 and led by former Vice President Joe Biden, the initiative aims to complete 10 years of cancer research by 2020. High-level goals include the expansion of cancer prevention and detection strategies, minimizing treatment side effects, establishing a network to allow for direct patient involvement, increasing data sharing, and devoting research time and money to immunotherapy. Many doctors and researchers envision immunotherapy becoming the best treatment option we’ve seen in years. Still early in its development, this cancer treatment utilizes the body’s natural defense system to fight off cancer cells. These cells, normally hidden from the body’s immune system, are unveiled when one of three main types of cancer immunotherapy is involved: First used in 1981 to fight liver cancer, cancer vaccines are a form of immunotherapy. Therapeutic vaccines are injected once a person is already diagnosed with cancer as a form of treatment to stop growth or recurrence. (Although vaccines for cancer can also be preventative, like the HPV vaccine, that...

The immune system is a complex network that attacks foreign substances like germs and viruses. But cancer has historically been resistant to the body’s natural defenses, mainly because the body doesn’t see it as foreign. T-cells participating in the immune system’s response are unable to recognize the rogue cancer cells because they carry proteins called PD-L1 that act like masks allowing the cancer to blend in with other normal cells. Immunotherapy is a treatment that essentially simulates natural human antibodies to block the PD-L1 protein and expose the tumor for T-cells to attack. The Past The rise of immunotherapy has been experimental in nature. Beginning in the late 1800s, a New York surgeon named William Coley saw impressive responses from children with sarcoma that he treated with bacterial extracts. However, due to the success of antibiotics, immunotherapy research largely fell by the wayside. A few small breakthroughs during the 1900s, including the introduction of the first cancer prevention vaccine in 1981, eventually led to the continued growth we’re seeing today. The Present In the wake of multiple government-backed research initiatives, including the Human Genome Project of the 1990s and early 2000s and the Cancer Moonshot announced in 2016, immunotherapy has once again surged into the spotlight as an emerging cancer treatment. Growing antibiotic resistance, the negative side effects of chemotherapy and radiation and the overall low survival rates of...

President Trump’s new education budget proposes to dedicate no money—that’s right, zero—to fund mental health services and other student support services for public schools. Previously, the government provided schools with $1.65 billion in funding for various initiatives, including mental health services. But, in an attempt to reduce the federal government’s role in education, Trump and Education Secretary Betsy DeVos have decided it’s best to cut all funding for these important student services. Lack of funding is a serious issue for a number of reasons. According to the NIH, just over 20 percent of children have had a seriously debilitating mental disorder either currently or at some point in their life. Nonetheless, according to the American Academy of Pediatrics, only 21% of children with mental health issues actually receive services. There is a disparity between ill children and treatment received, and this gap may grow if funding for school-based mental health services is slashed. The disparity may become an even greater challenge for students who live in areas where community-based mental health services are scarce or too expensive—without school-based services, these children’s options are severely limited. The new education budget’s lack of concern for mental health services may harm children’s health in the long run. A child’s mental disorder may worsen and continue into adulthood if not treated early and appropriately. That’s why school services are vital and even preventive—they...

Can stem cells really regrow teeth? It sounds like something straight out of a science fiction movie. For most dental patients with missing teeth, there are only a few options: getting dental implants or false teeth. And for dental patients with cavities the remedy usually is a filling or cap. But, what if you could get new teeth – real teeth growing right in your mouth. David Mooney and his team of researchers at Harvard’s Wyss Institute are working on making this science fact and not fiction. What’s his idea? To use lasers with stem cells and regrow teeth. He and his research team have developed a technique using a low-power laser. The laser’s job is to get stem cells to reform dentin. This could have huge implications for cosmetic dentistry, for wound healing, and even for bone restoration. Arthur Glosman DDS, famous cosmetic dentist in Beverly Hills specializing in dental implants, says: This could be the next big thing, even beyond teeth implants. Stem Cells and Regenerative Medicine But, what are stem cells, anyway? Stem cells are a class of undifferentiated cells that can differentiate into specialized cell types by using proteins called growth factors. Adult stem cells can divide, or self-renew on an indefinite basis. Adding different growth factors can force these cells to develop into a particular type of tissue. However, to accomplish this is not...

Combination antiretroviral therapy (ART) has been the preferred treatment for patients with HIV for 20 years. Since its inception in 1996, the therapy has continued to improve. Now, studies report that patients living with HIV who take the new ART drugs may look forward to near-normal life expectancy. In particular, people with the disease are likely to live 10 years longer than people who were infected with HIV in 1990s. A new study published in The Lancet reports advances in antiretroviral drug treatment (ART) that improve life expectancy for patients living with HIV. ART is the standard treatment regime for HIV patients. While ART cannot cure HIV, a combination of medications help patients live longer and reduce the risk of HIV transmission. ART was first introduced in 1996. One year after ART was introduced, the FDA approved Combivir, a combination drug taken as a single daily tablet, which made taking daily medication HIV patients easier. Since then, ART initiation has improved by leaps and bounds, making medication management easier for patients. The study was co-authored by a collective called “The Antiretroviral Therapy Cohort Collaboration.” Research was conducted by an international team led by the University of Bristol in the UK and funded by the UK’s Medical Research Council, Department for International Development and the European Union. The study combined data from 18 European and North American cohorts enrolled in...

All it took was one-hundred words to kill over hundreds of thousands of Americans. A new report from the New England Journal of Medicine tells the story of how this short doctor’s note helped facilitate today’s American opioid epidemic: We found that a five-sentence letter published in the Journal in 1980 was heavily and uncritically cited as evidence that addiction was rare with long-term opioid therapy. We believe that this citation pattern contributed to the North American opioid crisis by helping to shape a narrative that allayed prescribers’ concerns about the risk of addiction associated with long-term opioid therapy. In 2007, the manufacturer of OxyContin and three senior executives pleaded guilty to federal criminal charges that they misled regulators, doctors, and patients about the risk of addiction associated with the drug. Our findings highlight the potential consequences of inaccurate citation and underscore the need for diligence when citing previously published studies. Since opioids were not widely used forty years ago, so doctors did not have much data to support addictive properties. The New England Journal of Medicine performed a bibliometric analysis of the validity of the 1980 letter. There were 608 scholars that cited the letter as proof since 1980. 72% cited that addiction was rare among those prescribed opioids; however 81% of scholars did not mention that the patients were hospitalized when they receive the prescription. Because so many scholars cited the letter...

There are many misconceptions about teaching hospitals, but the easiest mistake to make is to assume that because residents with less experience are involved at the hospital it means that patients will receive a lower standard of care. However, a new study published in JAMA shows that what may sound like a logical conclusion does not hold up. When researchers in the Boston area, led by Laura G. Burke, MD, MPH, Instructor in Emergency Medicine at the Harvard T.H. Chan School of Public Health, set out to examine this very question, they found that data from previous studies was, in many cases, decades old. To gather new data, the researchers looked at hospitalizations from 4,483 different hospitals across the U.S, taking only data from 2012-2014. The researchers then examined the mortality rates for specific medical conditions and surgeries, such as stroke, heart failure or hip replacement. In their analysis of 21.5 million hospitalizations of Medicare patients, the researchers found that the 30-day mortality rates were significantly better at major teaching hospitals, even when patient data was adjusted for age and the severity of illness, or when the hospital data was adjusted for size of hospital, etc. The 7-day and 90-day mortality rates were also better at the major teaching hospitals when compared to non-teaching hospitals. Because of their close association with medical schools, teaching hospitals may be at the...